


Under My Skin

by Zelos



Series: Power Overwhelming [1]
Category: Captain America (2011), Iron Man (Movies), Marvel (Movies), Marvel Avengers Movies Universe, The Avengers (2012), Thor (2011)
Genre: Community: avengerkink, Courage, Ensemble Cast, Friendship, Gen, Heroism is difficult, Job Hazards, Male Friendship, Male-Female Friendship, Medical Procedures, Medical Trauma, Prompt Fic, Serious Injuries, Sort of hurt/comfort, Sort of whump, Super Soldier Serum, Super metabolism has drawbacks, Surgery, Team, Unexpected disadvantages
Language: English
Status: Completed
Published: 2012-09-10
Updated: 2012-09-10
Packaged: 2017-11-14 00:13:54
Rating: Teen And Up Audiences
Warnings: Creator Chose Not To Use Archive Warnings
Chapters: 1
Words: 2,514
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/509280
Author URL: https://archiveofourown.org/users/Zelos/pseuds/Zelos
Summary: <blockquote class="userstuff">
              <p>Written for a <a href="http://avengerkink.livejournal.com/9218.html?thread=20658434#t20658434">prompt</a> on avengerkink:</p><blockquote>
  <p>I want to see something where, for whatever reason, Steve's accelerated healing turns out to be a bad thing. Something where the faster healing is making things worse. I would prefer something other than the standard, super-healing allows for more torture without death.</p>
</blockquote><p>“He's lucky – to have the serum, to have you all.”  Tony wasn't sure about that first part.</p><p>When one faced death and destruction every day on the job, there were many advantages to having a healing factor...and a great many disadvantages as well.</p>
            </blockquote>





	Under My Skin

**Author's Note:**

  * Translation into Русский available: [Под кожей](https://archiveofourown.org/works/6766252) by [Likoris](https://archiveofourown.org/users/Likoris/pseuds/Likoris)



> I am not a medical student and do not work in the medical field. This is the result of a lot of research, and all mistakes are my own. Hopefully I struck a decent balance between handwaving Steve's physiology and realistic medical procedures.
> 
>  **WARNING:** descriptions of medical procedures herein. Not terribly graphic as I can't do it accurately enough for my liking, but if that's your squick, take note.

Tony stepped into the surgery room, the doors of the decontamination chamber hissing shut behind him. “Sitrep.”

The lead nurse looked up at him, not even surprised at his terminology. “Better, but not great.” Tired lines were set deep in her face, her voice only slightly muffled by the mask. “Blood pressure's low, but we've gotten two bags in him, third's still wide open.” She glanced back at the semi-lucid figure on the table. “The transport team stopped the bleeding in his leg, but CT shows a subdural hematoma.”

Tony paused to let JARVIS translate all that for him, and shuddered.

The decontamination chamber hissed again, and Thor stepped in, the hospital scrubs and face mask at home with the worry in his eyes. His gaze, so sombre and subdued, raked over the soldier's pale face, the labourous, shallowing breaths. “How is he?”

“As well as can be expected.”

Thor stared dubiously at the deformations under purpling skin, and did not look convinced.

Tony clanked his way over to the table; Steve's eyes – pupils blown wide and uneven – tried to follow his movements, the hotrod-red sparking recognition beneath the haze. “Hey.” The gauntlets brushed the soldier's shoulder, gentleness belying strength. “You'll be okay.”

Thor took up his position on Steve's other side, making sure to not trip over the IV stand. Large gloved hands laid on Steve's bicep, fingers wrapping around trembling muscle and pallid skin. Around them, the nurses fluttered about, applying Betadine, preparing warm blankets, checking the Foley. The gel grounding pad was draped on Steve's thigh, sterile drapes laid over the body. Someone was counting the instruments and needles, staccato murmurs in the background.

The doors hissed open one final time, two men striding in. Dr. Summers took in the sight, narrowed his eyes at the nurses. “Get him on the ventilator.”

“He's breathing fine,” Tony snapped, one gauntletted hand hovering protectively over Steve's face.

The lead surgeon smiled humourlessly, just enough so his mask twisted. “For now. We're cutting a couple of holes in his chest and head, Stark – _without_ anesthesia. You tell me he can breathe through that. C'mon,” that was to the nurses, “ventilator, chest tube, then we get started. Daylight's burning!”

Tony swore softly. Steve made a noise of protest as a nurse pried his mouth open, and he swore again.

“Steve?” He fervently loved that he'd painted the suit _his_ version of 'discreet'. Recognition was distraction, and that was all Steve had right now. “Cap, look at me _._ ” That blade-like...thing...with the light slid into Steve's mouth; Tony flinched hard beneath his faceplate, glad Steve couldn't see his panic. He had enough of his own.

“Hold him steady, you two,” and he and Thor clamped down hard against Steve's struggles as the plastic tube slid between the vocal cords, cutting short another groan.

“Bagged,” called a nurse; Summers listened briefly to the whoosh of air, and nodded his approval.

“On the ventilator.”

“Positioning seems okay. Where's that chest tube?!”

“Right here, sir. Ready for placement.”

“Pulse ox okay!”

“How long will this take?” Tony asked desperately, his grip already slipping from Steve's sweat.

“We haven't even started yet.” There was that humourless smile again in Summers' eyes. “Betwen the lap, flail chest, and hematoma? At least an hour or three. Aren't you glad you're not a super soldier, Stark?”

Whatever response Tony could've had for that was cut off as the scalpel split skin and muscle; Steve _thrashed_ under Tony and Thor's hands, and it was all Tony could do to keep his grip.

Thor was praying to the Allfather. Tony was too.

 

“He blacked out, sir.”

“If we're lucky, it'll last two minutes.” Summers looked visibly strained. A patient like Captain America tested the best of men, and SHIELD's top surgeons were no exception. “Ribs eight through twelve have been reduced, but they need external fixation.”

“Antibiotics are going, sir.” Someone affixed another bag of blood.

“I thought Steven does not...require...medicine,” Thor ventured hesitantly. He visibly winced as Steve began stirring, panicked struggles against the hands of friends, frantic eyes rolling under lowered lids. “Nor are they...effective on him.”

“Not usually.” Summers didn't even look up. “But when I cut a couple of holes in you, that's not 'usually'. And antibiotics do work. Recovery's miserable enough for Captain Rogers. Not risking infection on top of that.”

Tony kept his gaze on Steve's face, because that was the only safe place to look – safer than Summers stapling Steve together, anyway. He memorized the cut of cheekbone, the dry, cracked lips, the ventilator tube silencing the screams. There were tears streaking down Steve's face, veins bulging in his neck. Steve jerked at every new staple; Tony's heartbeat counted each one.

“We're ready for the burr, sir.” The nurse motioned Thor over, showed him how to hold Steve's head. The shaved patch of scalp glistened in the light, the antiseptic still drying. Another nurse disconnected Steve's ventilator tubing, suctioned out his mouth, and reconnected it all before Steve finished gagging, and before Tony could protest.

The whine of the drill made Tony glance up, and he instantly regretted it. Tony's seen a lot in his life, seen blood and guts and gore sprayed on the streets after a bad call or an uncontained battle. He's seen corpses charred by fire and crushed by debris and pulpy, bloody messes that couldn't be recognizable as human, but he's never seen anything so terrifying as a drill approaching the skull of a man he called friend.

The whine dropped in pitch as the drill made contact; Steve's back _arched_ , eyes popping open, and nearly flung Thor and Tony off entirely as the bit bore into bone.

“ _Hold him!!_ ” And Tony closed his eyes and clung on for dear life, Captain America coming apart under his hands.

 

Tony and Thor stumbled out of the ICU's decontamination chamber an eternity later, and ran headlong into Bruce, Natasha and Clint waiting outside. “How is he?”

“ _Christ_ ,” and that wasn't eloquent and said fuck-all, but Tony'd burned out his last brain cell a long time ago. He headed for the nearest wall to sag against, but Bruce intercepted him and okay, that worked too; he laid his helmeted head against Bruce's shoulder and just shook.

Bruce stiffened under him. Thor's voice cut through the rising panic before anyone else could speak: “He will recover. The operations were successful.”

The tension palpably halved, and Bruce's arms wrapped around Tony's shoulders. “Tony?”

“ _Christ_ ,” Tony repeated, and slid off his faceplate to bury his face into Bruce's shirt. He knew he smelled like bile and vomit and his entire suit stank of it and he didn't care, he'll buy Bruce replacements and it was no worse than pissing in the suit. Face still rumpling Bruce's shirt, he scrubbed violently at his eyes, trying to scrub the past four hours from his mind: the ribs, flashing sickening white, screws and plates affixing fragmented pieces; the long midline incision, skin splitting under blades, lumps of red and slime exposed and fuck those were _organs_ ; the peeled back scalp, the whirring of the drill, and _holy fucking shit_ , they were cutting open Steve's _brain_ -

“ _Tony_ ,” Bruce repeated, and he realized that he was sobbing. He pulled back, dashed his hand across his eyes again, stared down at the ground. Clint laid a hand on his shoulder, and he shrugged him off.

“We _cut him open_ ,” Tony rasped out, his hands tightening convulsively at his sides; Steve's face flashed across his eyes, twisted in terror and agony and he'd see it for _weeks_. “He was _there_ , and we _cut him open_ \- ” And goddamn it, he _knew what it was like_ – knew better than anyone, after Afghanistan, but how the _fuck_ did it not occur to him that since the War, since the goddamned serum, that Steve'd been _cut open_ every time he went under the knife? All those broken bones and dislocated joints and bullet wounds that came with the job, then and now, and maybe he and Clint and Natasha weren't _super_ but at least they could be _put under_ -

JARVIS had turned off his visuals partway into the drilling process, to Tony's relief and shame. JARVIS'd promised, sounding a little ill himself, to turn it back on if there was anything Tony couldn't miss.

Truthfully, Tony didn't know if he could watch Steve expire on the table if it came to it. He's glad he didn't find out.

“He will recover,” Thor assured them again, though his shaken expression did not lend his usual authority to the words. The god looked haunted.

“He will,” agreed a new voice, and they turned as one to find Summers just outside the doors of the ICU. The tension had bled out of the man, the frightening competency, and now he was just another man in new clean scrubs with white in his hair and muted kindness in his eyes. _He must see this a lot_ , Tony thought hysterically, and superheroes weren't so different from civvies when it was one of their own on the table.

“I just wanted to say thank you,” the surgeon said simply, and he sounded so _tired_. What was the pressure like, to operate on Captain America? “Sorry for making you do it, but...we would've lost him otherwise.”

“...I'm sorry?” That was Natasha, since neither Tony nor Thor seemed to be capable of speech.

Summers shrugged, clipped and sardonic. “I don't know what happened back then, if he was just lucky. So far, with SHIELD, he's only had minor procedures – a cast, couple of wraps, foreign objects in extremities. Nothing really serious. Nothing life-threatening. He's always managed to...stay in control.” A wry twist of mouth. “Don't think he could've done that while we were drilling holes into his skull, no matter how good of a man he is – and god knows _we_ can't hold him down. If he was left untreated, or if something had slipped...”

Bruce paled, Clint stiffened, Natasha clenched her jaw. Something knotted deep in Tony's gut.

“But he will recover,” Thor said, more of a question than a statement.

“He should. He's lucky – to have the serum, to have you all.” Tony wasn't sure about that first part. Summers waved, a laconic twitch of fingers, the slightest tremble in his frame. “Until next time.”

“...next...time...?” And if that sounded strangled, well, who could blame him?

A quirk of brow, a smile that didn't reach his eyes. “Given your jobs, do you really think I won't have Captain Rogers on my table again? I hope the Iron Man and God of Thunder will be with him when he is.” Summers nodded briskly at their slack expressions. “Room 25 in the ICU, Mr. Stark, Mr. Odinson. Mind the nurses.”

And he disappeared back into the ward, leaving horrified silence in his wake.

 

Steve stayed in the ICU for nearly two weeks. He slept fitfully, shallow dozes frequently interrupted by movement, pain, the bustle of medical staff. The nurses came by every 15 minutes (later decreased to every hour) to check the gastric tube, his IVs, the host of machines. All vitals and physical symptoms were duly noted, the dressings regularly changed. Tony and Thor were given strict orders to keep the captain from pulling anything out.

The pair arranged a round-the-clock vigil, because recognition and distraction was all the comfort they could give, and no one wanted Steve to wake up alone. Sometimes they held his hand. Sometimes they talked to him, for all the good it seemed to do (not much). Mostly they just watched Captain America slide in and out of consciousness, with no other reprieve than his own healing.

“I am never letting you out of the Tower again,” Tony told him on his watch, and Steve's eyes flickered in what might have been a laugh. Or maybe Tony just imagined it.

Hill and Fury swung by too, though they were barred from entry like the others (Tony and Thor were exempt, being the nurses' hired muscle to hold Captain America down when needed). They conferred with the doctors. They talked to Thor and Tony, usually in short nods and clipped expressions that spoke more than words. It made Tony respect them more, in a vicious, hollow way; at least they saw what they asked of their agents, the costs in all their ugly glory.

If they had to make Steve hurt for their aims, it had damn well better be worth it.

By the fourth day, the ventilator had been switched to CPAP mode and Steve's shorn hair had grown in, the blond fuzz covering the rapidly pinking scar on his head. By the fifth day, he could stay lucid for 15 minute stretches, answering simple questions with blink patterns. The day after, he gained enough dexterity to write words on a pad (mostly 'hi' and 'ow'), and the doctors decided to take him off the ventilator.

Tony was on standby as just-in-case muscle, though Steve was lucid enough to not fight the staff. Tony also took the liberty of transmitting the procedures through JARVIS and the suit. The SHIELD doctors didn't even protest, since he'd already proven that his tech was shielded from their instruments; they just admonished “stay out of the way” and went back to adjusting the oxygen pressure on their machines and suctioning things Tony couldn't see.

“Deep breath, captain,” and Tony tensed where he stood. “Cough, as much as you can...applying vacuum...and _now!_ ”

The tube came free with not so much a _cough_ but a violent retching, the first sound Tony's heard out of Steve in nearly a week. Someone slapped a new oxygen mask on him and Steve's eyes rolled alarmingly in his head, but he managed to stall the panic with a slightly raised hand, just as someone began shouting about re-intubation.

The doctors and nurses were abuzz, checking vitals and monitors and talking excitedly amongst themselves. Tony caught bits on “rate of recovery” and “what about the chest tube?”; Steve ignored them all, braving the pokes and prods. His head lolled exhaustedly to one side, but he was staring right at him, as if mesmerized by the red and gold.

“Steve?” And fuck that shit about sterility and decontamination; the faceplate slid off, brown eyes meeting blue. Tony hurried over to the bed, almost crushing the chair he sat down in. “ _Steve_ ,” and that had four other voices layered overtop, cracking and relieved, JARVIS patching the others through to where they couldn't be.

Steve was trying to talk, not that it made it out through the mask, and the effort looked like it hurt. He coughed twice; Tony squeezed his hand. “Hey. Take it easy.”

Steve tried again, mouthing the words instead, and Tony read it as much from his expression as the actual words, shaky and relieved and alive: _I'm okay_. His fingers tangled with Tony's. _I'm okay._

 _Until next time,_ Tony thought, but didn't dare say it, and forced a smile onto his face.

**Author's Note:**

> Per 616 canon (and MCU hasn't changed much of the heroes' capabilities, so far), Steve is immune to drug intoxication, so all painkillers, anesthesia, stimulants, etc. are out. However, as antibiotics do not, strictly, act on Steve (rather, they act on the bacteria), I feel these should still work despite Steve's physiology.
> 
> There were a couple of places where I deviated from medical SOPs specifically to accommodate Steve. Let me know if there're any questions re: medical stuff I wrote.
> 
> Why I wrote this: I definitely accept that being superhuman means that they hurt less and heal faster, but as they're all still human the physiology should behave the same way. Steve might heal a broken bone in a day or three, but he's not going to get a compound break aligned without going under the knife (and can you imagine, given how fast he heals, how bad it'd be if he healed _wrong?_ ). Sure, a hematoma might not kill him as quickly, but if not drained, it still will...eventually. Medicine and healing aren't easy, and it's one of my favourite things when fandom shows medicine done realistically (to a point). (Field techniques are well and good, but proper medical treatment is very complicated - far more things need surgery than I expected!)
> 
> Not discounting the bravery of heroes in battle, but I find the recoveries, the physiotherapy, the months in between when they're not soaked with adrenaline but endless, constant pain...those moments are equally brave to me, if not more.
> 
> Tony went through a conscious surgery in Afghanistan. Steve undergoes one every time he gets hurt. And he still chose this.
> 
> Steve, I think, is a very brave man.


End file.
